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December 23, 2020 logo logo
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[Guidance Overview]

Exceptional Usefulness and Quality and Usefulness iconRecent Regs That Could Affect Private Health Insurance Coverage

"[T]he plan transparency requirements ... will: [1] Up-end almost every type of contract out there in the health insurance industry. [2] Release a treasure trove of data into the marketplace, and [3] Take an enormous amount of effort and money to implement.... If finalized, [the proposed HIPAA privacy regulation] is going to have a massive impact on individual people and all covered entities, which include providers, health insurers, and self-funded plans. It will also affect business associates of covered entities, like health insurance agents and brokers." Icon to read more

MZQ Consulting, LLC

[Guidance Overview]

Final Rules Provide Some Relief to Grandfathered Plans

"The final rule changes the maximum percentage increase for grandfathered group plans to be the greater of [1] the current standard (medical inflation plus 15 percentage points); or [2] the change in the premium adjustment percentage plus 15 percentage points. In general, the new method is expected to be approximately 3% higher, on average, than previously allowed." Icon to read more


[Guidance Overview]

Upcoming Deadline iconPaid Family and Medical Leave Benefits Become Available in Massachusetts on January 1: Is Your Workplace Ready?

"By now, you have notified your workforce about benefits and contributions, displayed a poster informing them of the same, determined the size of your workforce and who is a 'covered individual,' begun making deductions on behalf of eligible employees or applied for a private plan exemption, and more.... [On] January 1st, 2021, employees will become eligible to take leave under the PFML. Employers can prepare by consulting with counsel regarding your obligations, updating employee handbooks, and reviewing the types of leave your employees may be eligible to take." Icon to read more


[Guidance Overview]

IRS Finalizes Regs on Disallowance of Employer’s Deduction for Commuting Benefits

"Because employers generally can deduct expenses attributable to parking available to the general public but not expenses associated with qualified parking, the IRS requires employers to distinguish between the two types of parking expenses. Employers that provide parking benefits in a facility they own or lease, in particular, may need to model the various methods for calculating their disallowed deduction in order to find the optimal combination of ease and tax benefit. Employers that have been relying on the proposed regulations, or the IRS's interim guidance in Notice 2018‑99, may continue to rely on that guidance for expenses paid or incurred in taxable years beginning after 2017 and before December 16, 2020." Icon to read more

Thomson Reuters / EBIA

District Court Says Objective Evidence Is Not Necessary to Prove Disability

"In evaluating the evidence, the court rejected Aetna's argument that objective evidence was necessary to prove disability.... The court also discounted the opinions of Aetna's reviewing physicians. Judge Fischer acknowledged that she was not required to give deference to treating physicians, but found Plaintiff's treaters more credible." [Myers v. Aetna Life Ins. Co., No. 19-9555 (C.D. Cal. Dec. 17, 2020)] Icon to read more

Kantor & Kantor

New Law Protecting Virginians Against Surprise Medical Billing Takes Effect January 1

"Starting Jan. 1, individuals enrolled in either fully insured managed care health insurance plans issued in Virginia or the state employee health benefit plan cannot be balance billed successfully by an out-of-network provider for emergency services. Additionally, out-of-network providers cannot balance bill these individuals for certain non-emergency services during a scheduled procedure at an in-network hospital or other health care facility." Icon to read more

Augusta Free Press

Exceptional Usefulness and Quality icon2021 Consolidated Appropriations Act Includes Major FSA Relief

"[1] Full FSA carryovers from 2020-2021 and 2021-2022 plan years.... [2] Extended grace periods for 2020 and 2021 plan years.... [3] Health FSA spend down.... [4] Dependent care FSA relief for children who reached age 13... [5] FSA election change relief.... [6] Plan amendments may be retroactive." [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more

ABD Insurance & Financial Services

COVID Relief Bill Would Ban Some Surprise Medical Bills, But Not All

"Starting in 2022, when insurers and medical providers cannot agree on a payment rate, the legislation requires both parties to use an outside arbiter to set a fair amount ... That amount would be based on what other doctors and hospitals typically get paid for similar services. Patients could be charged what they might normally pay for in-network care, but not more[.]" [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more

Association of Health Care Journalists

COVID-19 Relief Bill Would Provide Tax Credit But No Mandate for Paid Sick/Family Care Leave

"Mandated FFCRA leave ends on December 31, 2020. As of January 1, 2021, [the relief bill provides that] covered private-sector employers may voluntarily provide paid leave that otherwise would have qualified for FFCRA if the FFCRA had not expired, and if they do, they may take the tax credit associated with this leave, The tax credit may only be taken for leave through March 31, 2021." [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more

Miller Johnson

COVID-19 Deal Would Extend FFCRA Tax Credits, But Not Mandate Leave

"[T]he FFCRA emergency sick leave and expanded FMLA leave mandates will indeed expire on December 31, 2020. However, [under the legislation,] covered private sector employers that allow employees to take leave that would have been mandated by the FFCRA if the law had remained in effect through March 31, 2021 may continue to claim a tax credit to cover the cost of the leave." [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more

Franczek P.C.

Benefits in General

Exceptional Usefulness and Quality iconCongress Approves Additional COVID Relief as Part of Government Funding Package

"The legislation extends to money purchase pension plans the option to permit coronavirus-related distributions (CRDs) ... Employers will be provided relief from partial plan terminations that could result from a reduction in workforce due to the COVID-19 pandemic.... Temporary special rules for health FSAs and dependent care FSAs ... Preventing surprise medical bills ... The legislation provides limited non-COVID-related disaster relief for certain federal disasters declared on or after January 1, 2020, and ending 60 days after enactment of this bill.... A CARES Act provision that permitted employers to provide student loan repayment benefits of up to $5,250 to employees on a tax-free basis has been extended to December 31, 2025." [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more


Year-End Appropriations and COVID-19 Relief Legislation Includes Many Employee Benefit Plan Provisions

"Congress has passed year-end appropriations legislation that includes a variety of provisions affecting employer-sponsored benefit plans -- some relating to the COVID-19 public health emergency and others with broader applicability.... [1] FSA relief.... [2] Surprise medical billing.... [3] Disaster relief.... [4] Student loan repayments.... [5] Partial termination relief.... [6] Meal deductions.... [7] Mental health parity expansion.... [8] Deductible medical expenses." [Editor's note: As of Dec. 23, the bill has not yet become law; it's future is uncertain.] Icon to read more

Thomson Reuters / EBIA

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HSA Deductions Not Deposited Into HSA Account -- How to Fix?

"Say an employer withheld HSA contributions in a prior year (2019). Never deposited them into the HSA. W-2 for 2019 showed the deductible HSA amounts. Now the error is discovered. Is it just a case of 'so sorry, too bad' and a revised 2019 W-2 must be done, or is there a 'correction' such as depositing the HSA funds now (although I suppose the HSA custodian might not allow it anyway)?" Icon to read more

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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